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Patients on glucagon-like peptide-1 receptor agonists (GLP-1RA) may continue therapy during elective pain procedures. A thorough risk assessment and shared decision-making are crucial for periprocedural GLP-1RA management.

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Area of Science:

  • Pain Management
  • Endocrinology
  • Pharmacology

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1RA) are increasingly used for type 2 diabetes and obesity.
  • Elective pain procedures require careful consideration of medication management.
  • Periprocedural management of GLP-1RA therapy is not universally standardized.

Purpose of the Study:

  • To summarize evidence and provide recommendations for managing patients on GLP-1RA therapy undergoing elective pain procedures.
  • To guide clinicians in periprocedural decision-making for GLP-1RA users.

Main Methods:

  • Review of current multi-society guidance statements.
  • Evidence summary and synthesis.
  • Development of clinical recommendations.

Main Results:

  • Patients without specific risk factors can generally continue GLP-1RA therapy during the periprocedural period.
  • Comprehensive risk assessment and shared decision-making are essential.
  • Conscious sedation should be evaluated case-by-case and is often unnecessary.

Conclusions:

  • Periprocedural GLP-1RA management should be individualized.
  • Collaboration between patient, prescribing team, performing physician, and anesthesia is vital.
  • Minimizing unnecessary interventions like conscious sedation is recommended.